Introduction
Urban Hellgren, Orjan Ericsson, Orjan Ericsson, Lars L Gustafsson in Handbook of Drugs for Tropical Parasitic Infections, 1995
Many of the drugs used for the treatment of tropical parasitic infections were introduced more than 30 years ago. Most of them are toxic and have complicated dosage regimens. Some drugs like melarsoprol, suramin, pentamidine and pentavalent antimonials have to be given parenterally for prolonged periods of time. With such treatment regimens, and the fact that most of these drugs are toxic, it is often difficult to complete the treatment. Because of the low economic incentive, pharmaceutical companies have shown little interest in developing new drugs to control diseases prevalent in less developed countries. Despite this, there has been notable progress in research in parasitic diseases and a few important drugs have been introduced for some diseases during the last two decades. This has largely been due to the efforts of the Tropical Diseases Research Unit (TDR) at the WHO in Geneva. Notable examples are the great hope raised by the recent introduction of more effective and safer drugs such as artemisinin, praziquantel, eflornithine and ivermectin. Ivermectin alone may have saved tens of thousands from blindness during the last few years. Even more exciting is the hope that a malaria vaccine may become available in the not too distant future.
An emerging treatment: Topical ivermectin for papulopustular rosacea
Published in Journal of Dermatological Treatment, 2015
Manal Abokwidir, Alan B. Fleischer
Ivermectin shows broad-spectrum anti-parasitic activity. It kills the Demodex mites that reside in the pilosebaceous units of patients with papulopustular rosacea. Ivermectin also has anti-inflammatory effects, it decreases cellular and humoral immune responses. Inflammatory mechanisms appear to play a dominant role in the development of rosacea inflammatory lesions. Additionally, there is some evidence that it shows antimicrobial activity against Myobacterium tuberculosis and Chlamydia trachomatis. The recent clinical studies of ivermectin on rosacea show that it was superior to vehicle in reducing inflammatory lesion counts, and its tolerability was excellent. Ivermectin displays antimicrobial, antiparasitic, antibacterial, and anti-inflammatory activities.
Ivermectin: a complimentary weapon against the spread of malaria?
Published in Expert Review of Anti-infective Therapy, 2017
Introduction: Ivermectin has transformed the treatment of parasitic diseases and led to incommensurable benefits to humans and animals. Ivermectin is effective in treating several neglected infectious diseases and recently it has been shown to reduce malaria parasite transmission. Areas covered: Malaria control strategies could benefit from the addition of ivermectin to interrupt the transmission cycle if it is a long lasting formulation or repeatedly administered. In turn, this will help also to control neglected infectious diseases where the elimination goal has been slower to achieve. Despite the relevance of using ivermectin for integrated and sustained disease control, there are still essential questions that remain to be addressed about safety and practicality. The efficacy in various malaria ecologies and the interaction between control tools, either drugs or insecticides, are also important to assess. Expert commentary: Overlapping distribution of several infectious diseases reveals the benefit of integrating control programs against several infectious diseases into one strategy for cost effectiveness and to reach the elimination goals. The use of ivermectin to control malaria transmission will necessitate development and testing of long-lasting formulations or repeated treatments, and implementation of these treatments with other disease control tools may increase the chance of successful and sustained control.
Comparison of oral ivermectin versus crotamiton 10% cream in the treatment of scabies
Published in Cutaneous and Ocular Toxicology, 2014
Mohamad Goldust, Elham Rezaee, Ramin Raghifar
Objective: Scabies is a relatively contagious infection caused by a tiny mite (Sarcoptes scabiei). Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. The aim of this study was to compare the efficacy and safety of oral ivermectin versus crotamiton 10% cream for the treatment of scabies. Methods: In total, 320 patients with scabies were enrolled, and were randomized into two groups: the first group received a single dose of oral ivermectin 200 µg/kg body weight, and the second group were treated with crotamiton 10% cream and were told to apply this twice daily for five consecutive days. Treatment was evaluated at intervals of two and four weeks, and if there was treatment failure at the two-week follow-up, the treatment was repeated. Results: A single dose of ivermectin provided a cure rate of 62.5% at the two-week follow-up, which increased to 87.5% at the four-week follow-up after repeating the treatment. Treatment with crotamiton 10% cream was effective in 46.8% of patients at the two-week follow-up, which increased to 62.5% at the four-week follow-up after this treatment was repeated. Conclusion: A single dose of ivermectin was as effective as one application of crotamiton 10% cream at the two-week follow-up. After repeat treatment, ivermectin was superior to crotamiton 10% cream at the four-week follow up. The delay in clinical response with ivermectin suggests that it may not be effective against all the stages in the life cycle of the parasite.